ental caries, also known astooth decayor acavity, is aninfectionusuallybacterialin origin that causes demineralization of the hard tissues

(enamel, dentin and cementum) and destruction of the organic matter of the tooth, usually by production of acid by hydrolysis of the food debris accumulated on the tooth surface .[1]If demineralization exceeds saliva and other remineralization factors such as from calcium and fluoridated toothpastes, these tissues progressively break down, producing dental caries (cavities, holes in the teeth). The two bacteria most commonly responsible for dental cavities are Streptococcus mutansandLactobacillus. If left untreated, thediseasecan lead to pain,tooth loss andinfection.[2]Today, caries remain one of the most common diseases throughout the world. Cariology is the study of dental caries.

The presentation of caries is highly variable. However the risk factors and stages of development are similar. Initially it may appear as a small chalky area (smooth surface caries), which may eventually develop into a large cavitation. Sometimes caries may be visible direct. However other methods of detection such asradiographs are used for less visible areas of teeth and to judge the extent of destruction. Lasers for detecting caries allow detection without radiation and are now used for detection of interproximal decay (between the teeth). Disclosing solutions are also used during tooth restoration to minimize the chance of recurrence.

Tooth decay disease is caused by specific types of bacteria that produceacidin the presence offermentablecarbohydrates such assucrose,fructose, andglucose.[3][4][5]Themineral content of teeth is sensitive to increases inacidityfrom the production oflactic acid. To be specific, a tooth (which is primarily mineral in content) is in a constant state of back-andforth demineralization andremineralizationbetween the tooth and surroundingsaliva. For people with little saliva, especially due to radiation therapies that may destroy the salivary glands, there also exists remineralization gel. These patients are particularly susceptible to dental caries. When the pH at the surface of the tooth drops below 5.5, demineralization proceeds faster than remineralization (meaning that there is a net loss of mineral structure on the tooth's surface). Most foods are in this acidic range and without remineralization, this results in the ensuing decay. Depending on the extent of tooth destruction, various treatments can be used torestoreteeth to proper form, function, and aesthetics, but there is no known method to regeneratelarge amounts of tooth structure, thoughstem cell related research suggests one possibility[citation needed]. Instead, dental health organizations advocate preventive and prophylactic measures, such as regularoral hygieneand dietary modifications, to avoid dental caries.[6]

Signs and symptoms The tip of a dental explorer, which is used for caries diagnosis. A person experiencing caries may not be aware of the disease.[7]The earliest sign of a new carious lesion is the appearance of a chalky white spot on the surface of the tooth, indicating an area of demineralization of enamel. This is referred to as an incipient carious lesion or "microcavity".[8]As the lesion continues to demineralize, it can turn brown but will eventually turn into a cavitation ("cavity"). Before the cavity forms, the process is reversible, but once a cavity forms, the lost tooth structure cannot beregenerated.[citation needed ] A lesion that appears brown and shiny suggests dental caries were once present but the demineralization process has stopped, leaving a stain. A brown spot that is dull in appearance is probably a sign of active caries. As the enamel and dentin are destroyed, the cavity becomes more noticeable. The affected areas of the tooth change color and become soft to the touch. Once the decay passes through enamel, the dentinal tubules, which have passages to the nerve of the tooth, become exposed and causes atoothache. The pain may worsen with exposure to heat, cold, or sweet foods and drinks.[1]Dental caries can also causebad breathand foul tastes. [9] In highly progressed cases, infection can spread from the tooth to the surroundingsoft tissues. Complications such ascavernous sinus thrombosis andLudwig's anginacan be life-threatening.[10][11][12] [

edit]Causes There are four main criteria required for caries formation: a tooth surface (enamelor dentin); caries-causing bacteria; fermentablecarbohydrates(such assucrose); and time.[13]The caries process does not have an inevitable outcome, and different individuals will be susceptible to different degrees depending on the shape of their teeth, oral hygiene habits, and the buffering capacity of their saliva. Dental caries can occur on any surface of a tooth that is exposed to the oral cavity, but not the structures that are retained within the bone.[14]All caries occurs from acid demineralization that exceeds saliva and fluoride remineralization, and almost all acid demineralization occurs where food (containing carbohydrate like sugar) is left on teeth. Though most trapped food is left between teeth, over 80% of cavities occur inside pits and fissures on chewing surfaces where brushing, fluoride, and saliva cannot reach to remineralize the tooth as they do on easy-to-reach surfaces that develop few cavities.

Teeth There are certain diseases and disorders affecting teeth that may leave an individual at a greater risk for caries.Amelogenesis imperfecta, which occurs between 1 in 718 and 1 in 14,000 individuals, is a disease in which the enamel does not fully form or forms in insufficient amounts and can fall off a tooth.[15]In both cases, teeth may be left more vulnerable to decay because the enamel is not able to protect the tooth.[16] In most people, disorders or diseases affecting teeth are not the primary cause of dental caries. Ninety-six percent of tooth enamel is composed of minerals.[17]These minerals, especiallyhydroxyapatite, will become soluble when exposed to acidic environments. Enamel begins to demineralize at a pH of 5.5.[18]Dentinandcementumare more susceptible to caries than enamelbecause they have lower mineral content.[19]Thus, when root surfaces of teeth are exposed from gingival recession or periodontal disease, caries can develop more readily. Even in a healthy oral environment, however, the tooth is susceptible to dental caries. The anatomy of teeth may affect the likelihood of caries formation. Where the deep grooves of teeth are more numerous and exaggerated, pit and fissure caries are more likely to develop. Also, caries are more likely to develop when food is trapped between teeth.